KATHMANDU: Approximately 3 million Nepalis, constituting 10 percent of the population, are grappling with some form of kidney ailment, as stated by medical experts.
Today, on World Kidney Day, global attention is drawn to the critical issue of kidney health under the theme ‘Equal Access to Kidney Treatment and Safe Medical Practice’.
The World Health Organization (WHO) reports a staggering figure of 1.7 million deaths annually attributed to severe kidney disease.
Lack of awareness initiatives from the government compels kidney patients to bear exorbitant expenses for treatment.
Despite substantial governmental expenditure dedicated to addressing kidney issues, doctors note a steady rise in affected individuals due to deficiencies in diagnosis awareness.
In a positive stride, the government has initiated free kidney transplant programs, allocating approximately five and a half lakh rupees per person for transplant procedures across 55 enlisted hospitals.
Additionally, the government is earmarking funds for cross-checks and medications.
The Act specifies that spouses, children, parents, adopted children, siblings, grandparents, grandchildren, parents-in-law, step-parents, step-siblings, uncles, aunts, nephews, nieces, and other close relatives can donate organs.
However, healthcare professionals stress the importance of early detection to prevent the onset of kidney diseases rather than solely focusing on treatment post-affliction.
Status of Kidney Disease and Transplantation in Nepal
Currently, kidney transplant services are confined to only ten hospitals nationwide, with seven located in the Kathmandu Valley and three in other provinces.
Despite a demand that sees 3,000 Nepalese citizens experiencing kidney failure annually, the country has witnessed only 2,121 kidney transplants over the past 15 years due to various logistical challenges, according to Dr. Prakash Paudel.
Dr. Paudel highlights that, based on contemporary medical standards, 10 percent of Nepal’s total population grapples with some degree of kidney problem.
Among them, a significant portion requires critical attention.
Approximately 300,000 Nepalese suffer from kidney-related issues, with 10 percent necessitating transplantations.
Though kidney transplantation commenced in Nepal in 2065 BS, access remains limited for the general populace.
Presently, only 15 hospitals, both private and governmental, are licensed for transplant procedures nationwide.
However, operational constraints mean that only 11 hospitals are actively providing transplant services.
Health institutions such as the Shaheed Dharmabhakta National Transplantation Center in Bhaktapur, Tribhuvan University Teaching Hospital, Bir Hospital, and Grande Hospital in Kathmandu, along with KIST, Sumeru Nidan, and MediCiti Hospitals in Lalitpur, are among those offering transplant services.
Similarly, outside Kathmandu, facilities such as the Pokhara Institute of Health Sciences, College of Medical Sciences in Chitwan, and Nobel Medical College in Biratnagar cater to the transplantation needs of patients.
Kathmandu Medical College, Thapathali-based Norvic Hospital, Chitwan Medical College, and Karnali Pradesh Hospital in Surkhet have yet to initiate transplant services despite holding licenses for the same.
Legal Framework Surrounding Kidney Transplantation
The Transplantation of Human Body Organs (Regulation and Prohibition) Act, 2055 BS has undergone amendments to streamline kidney transplantation procedures.
Under this legislation, 52 relatives, including immediate family members, are eligible to donate organs.
Symptoms may include nausea, fluctuations in urine output, urinary abnormalities like foaming, persistent fatigue, loss of appetite, hematuria (blood in urine), dry or itchy skin, muscle pain, insomnia, and fever.
The Act specifies that spouses, children, parents, adopted children, siblings, grandparents, grandchildren, parents-in-law, step-parents, step-siblings, uncles, aunts, nephews, nieces, and other close relatives can donate organs.
Additionally, individuals within extended family ties such as in-laws, cousins, and step-relatives are included in the list of potential donors.
Furthermore, the law mandates a minimum two-year uninterrupted relationship in cases of adopted children and in-laws seeking to donate organs.
Additionally, the Regulation on Human Organ Transplantation 2073 facilitates organ donation (exchange) among two or more family members.
Moreover, provisions are made for organ donation from individuals declared brain dead by medical professionals prior to their demise.
Challenges in Implementation
Despite legal provisions easing the process, practical hurdles hinder significant progress in kidney transplantation.
Dr. Paudel highlights the reluctance of potential donors, citing deep-rooted superstitions and familial hesitations as major barriers.
Moreover, even when family members consent, issues such as hereditary diseases, diabetes, and societal pressures often impede organ donation from within families.
Dr. Paudel emphasizes the potential for both donors and recipients to lead healthy lives post-transplantation through dietary and lifestyle adjustments.
Understanding the Spectrum of Kidney Disease
Kidney disease manifests through various causal factors, ranging from congenital conditions to lifestyle choices and dietary patterns.
Infections top the list as the primary instigator of kidney ailments, alongside issues like stones and prostate complications.
It is imperative to refrain from self-medication and adhere to prescribed medications only. Routine health checkups are indispensable, especially for individuals aged 40 and above, as recommended by Dr. Paudel.
Additionally, conditions such as diabetes, high blood pressure, and improper medication usage contribute significantly to the risk of kidney damage.
Recognizing Symptoms
Detecting kidney disease can be challenging, as symptoms may not always be apparent until sudden kidney failure occurs.
Symptoms may include nausea, fluctuations in urine output, urinary abnormalities like foaming, persistent fatigue, loss of appetite, hematuria (blood in urine), dry or itchy skin, muscle pain, insomnia, and fever.
Any combination of these symptoms warrants suspicion of kidney disease.
Preventive Measures
To mitigate the risk of kidney disease, adopting healthy dietary practices is important.
A diet rich in fresh, nutritious foods is recommended, while limiting daily salt intake to less than 5 grams aids in kidney health.
Adequate hydration tailored to individual needs is crucial. Avoidance of smoking and alcohol consumption is advised.
Incorporating regular physical activity, with at least 30 minutes of exercise daily, is beneficial.
It is imperative to refrain from self-medication and adhere to prescribed medications only. Routine health checkups are indispensable, especially for individuals aged 40 and above, as recommended by Dr. Paudel.
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